title: Prognostic significance of DNA-ploidy in a series of 690 primary breast cancer patients.
abstract: Flow cytometric DNA-ploidy measurements were performed on paraffin-embedded and fresh tumor specimens from 690 patients with Stage I-III breast cancer. The conventional classification of DNA-ploidy (diploid versus aneuploid) was compared with a division of tumor ploidy into 5 classes based on DNA index (DI) range. The DI-classification showed a better correlation with tumor size and TNM stage than the conventional classification. Aneuploidy was associated with an impaired survival and distant relapse-free survival (p = 0.02) but the DI-classification improved the discrimination between different prognostic groups of patients. In general, this indicated a more aggressive phenotype for tumors evolved via polyploidization. Hyper-tetraploidy (DI greater than 2.10) indicated a very poor prognosis in pre-menopausal patients. No prognostic effect of aneuploidy and DI-class was found in node-negative and TI patients. Cox multivariate regression analysis showed that aneuploidy was an additional prognostic factor to nodal status (I less than or equal to N less than or equal to 3, N greater than 3 vs. N = 0) and tumor size (T2-4 vs. TI) for overall and distant relapse-free survival. Subdivision according to DI-class did not improve the prognostic power of DNA-ploidy due to stronger correlations with established prognostic factors.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Beerman
authors.forename: P M
authors.initials: PM
authors.lastname: Kluin
authors.forename: J
authors.initials: J
authors.lastname: Hermans
authors.forename: C J
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: C J
authors.initials: CJ
authors.lastname: Cornelisse
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D016009:Chi-Square Distribution; D004273:DNA, Neoplasm / Q000032:analysis / Q000235:genetics*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D012044:Regression Analysis; D016019:Survival Analysis
chemical_list: D004273:DNA, Neoplasm